Often, when it is someone’s first time attending a physiotherapy assessment they do not know what to expect. I thought I would write a brief blog outlining the fundamentals of a physiotherapy assessment in the practice setting and how the assessment determines what treatment comes next.
The assessment tends to be longer than a treatment session because there is a discussion element at the start of the session in addition to the physical examination. To begin with we discuss why you are attending, expanding on signs and symptoms. We also discuss lifestyle and general health. These questions can sometimes appear a little personal but it is important that the physiotherapist asks them when it is relevant because it helps to determine what may be contributing/causing your problem and then to decide what needs to be looked at and tested in the physical examination. This is known as the subjective examination. This aspect of the assessment is particularly important if you have come directly to the physiotherapist without a referral from a doctor because the physiotherapist is the first health care professional to assess and diagnose your problem. The amount of time spent on the subjective is variable, depending on whether your history is complex or more straight forward. The subjective assessmenthelps determine what is assessed in the physical examination.
The physical examination follows the subjective assessment. During this part the physiotherapist will observe you both statically and during movements. They will palpate and feel the affected area, and often areas above and below the problem area. It can be indicated to look above and below the problem location because on occasion the problem is being caused somewhere else and the problems you can experience can be symptoms of the problem but not the actual cause. In addition, the physiotherapist looks at muscle strength, range of movement and ability to carry out functional tasks (for example standing on one leg). To help the physiotherapist determine whether it is a structural, ligament, muscle, tendon, cartilage, nerve problem the physiotherapist may well carryout special tests which are specific to a particular joint.
The information attained during both sections of the assessment will allow the physiotherapist to establish a cause of the problem and therefore a diagnosis. A problem list and treatment plan can then be established and discussed with you, with an explanation of what treatment would be appropriate and why. Physiotherapists are always observing and reassessing so over time, depending on progress and how you are responding to the treatment, the treatment plan may change. This will always be communicated by the physiotherapist. If you are ever unsure of the reasoning behind a specific treatment choice, always ask!
If you have read this and wonder whether a physiotherapy assessment would be beneficial to you give me a call, we can discuss your problem and determine the next step together (What is Physiotherapy?).